Anastomosis staplers generally include multiple rows of staples, with a cutting blade disposed between adjacent rows. The blade is actuated subsequently to the firing of the staples.
There are at least two kinds of anastomosis operations. Linear gastro-intestinal anastomoses involve the use of linear multiple-fire surgical staplers which can sever, for example, an intestine while applying rows of staples to the severed organ on opposite sides of the cut. End-to-end or intra-luminal anastomoses involve the insertion into a tubular organ (e.g., an intestine) of staplers with circular arrays of staples fired in an axial direction.
Linear anastomoses staplers have multiple staples in linear arrays. The staples are fired between jaws which are maintained in a closed configuration during the firing of the staples. The staples are fired sequentially by an ejector rod with a camming surface at a distal end. As the rod is pushed in the distal direction, the staples are pushed in sequence from one jaw against the other jaw, which serves to close the staples in a conventional process.
During an end-to-end or intra-luminal anastomosis operation for connecting ressected bowel sections, a stapling member at the distal end of a rigid metal tube is inserted through a patient's rectum so that the stapling member is flush against a closed free end of an intestinal segment. Through an open-abdomen incision, an anvil member is inserted into another intestinal segment which is then closed at the free end, e.g., by a purse string suture which has been sewn around the mouth of the organ. The anvil member is then connected to the stapling member through the closed ends of the intestinal segments. The anvil member and the stapling member are brought close to one another via a screw mechanism in the metal tube, thereby clamping the closed ends of the intestinal segments to one another between the anvil and the stapling member. Subsequently, staples are ejected from the stapling member in a circular array, while the closed ends of the intestinal segments are cut along the array of staples, thereby forming an internal opening between the connected segments of intestine.
The above-described operation is open abdominal surgery and involves all of the procedures and safeguards necessary for such surgery. For example, because of extensive blood loss, the patient may have have to be provided with a transfusion.